Knowles describes the learning contract as the “most effective strategy” to promote self-directed learning¹. The first task assigned to us, as part of the INTAPT course, was writing learning contracts for our scholarly projects. By background, I am an early-career Nephrologist, who is involved in different educational activities and is heavily invested in Point-of-Care ultrasound training for Nephrology and Internal Medicine trainees at Sunnybrook Hospital. As part of my scholarly project, I want to create and implement a Point-of-Care ultrasound curriculum for Nephrology trainees rotating through Sunnybrook Hospital.

As it was my first time creating a learning contract, I considered it challenging. At my first attempt, I set quite ambitious goals, but with my course instructor, Judith’s guidance, I was able to simplify them and make them more achievable. Since I chose Kolb’s experiential learning theory for my project, my first goal was to correctly identify and understand its various stages. To achieve my goal, after I learned about Kolb’s theory in the class, I read “Experiential Learning- Experience as the source of learning and development (2nd edition)” by David A. Kolb², and also studied the different journal articles, as well as other online resources available on this theory. I was able to correctly demonstrate all the four stages of Kolb’s cycle during my poster presentation.

My second objective was to detect an effective scenario where experiential theory was used for Point-of-Care ultrasound curriculum development. I glanced through different journal articles and other online resources, and I did find some articles where Kolb’s theory was used to develop a successful point-of-care ultrasound curriculum^3,4. I discussed my project with other faculty members at my institute involved in curriculum development as well, and decided to create self-study notes.

Simulation-based learning is an important tool for healthcare education, specifically for development of clinical skills⁵. Another key objective in my learning contract was to appreciate the different ways simulation can be used in delivering standardized Point-of-care ultrasound training. I studied different articles and online resources, as well as had discussion with my peers and course instructors around this topic. Luckily, the topic of my workshop presentation was “Simulation in Healthcare education,” so I was able to demonstrate my research on the topic.

“The best learning takes place when the learner takes charge.”

– Seymour Papert

At the end of this task and after accomplishing my goals, I realized the importance of developing learning contracts as part of adult and self-directed learning. Self-directed learning is the pedagogical outcome of Knowles’ theory^{6, 7}. It is based on the concept that learning outcomes are best achieved when the learners take responsibility of their learning by diagnosing their learning needs, formulating their learning goals, identifying the resources to meet their goals, selecting and implementing appropriate learning strategies and evaluating their outcomes. I feel that by creating a learning contract, I was able to identify my own learning goals and devise a strategy to achieve my outcomes, which gave me a sense of accomplishment.

References:

1. Knowles, M. S. (1986). Using Learning Contracts. Jossey-Bass.
2. Kolb, D. A. (2014). Experiential Learning. Pearson Education.
3. Russell, Frances M., et al. “Design and Implementation of a Basic and Global Point of Care Ultrasound (POCUS) Certification Curriculum for Emergency Medicine Faculty.” The Ultrasound Journal, vol. 14, no. 1, Dec. 2022, p. 10. DOI.org (Crossref), https://doi.org/10.1186/s13089-022-00260-y.
4. Buhumaid, Rasha, et al. “From Novice to Proficient: A Longitudinal Study of POCUS Skill Development through a Hybrid Certification Program in the United Arab Emirates.” BMC Medical Education, vol. 25, no. 1, Apr. 2025, p. 568. DOI.org (Crossref), https://doi.org/10.1186/s12909-025-07138-2
5. Motola I, Devine LA, Chung HS, Sullivan JE, Issenberg SB. Simulation in healthcare education: a best evidence practical guide. AMEE Guide No. 82. Med Teach. 2013;35(10):e1511-e1530. doi:10.3109/0142159X.2013.818632
6. Robinson, J. D., & Persky, A. M. (2020). Developing Self-Directed Learners. American journal of pharmaceutical education, 84(3), 847512. https://doi.org/10.5688/ajpe847512
7. Taylor, D. C. M., & Hamdy, H. (2013). Adult learning theories: Implications for learning and teaching in medical education: AMEE Guide No. 83. Medical Teacher, 35(11), e1561–e1572. https://doi.org/10.3109/0142159X.2013.828153